| The Illumination Foundation | |
|
248 Union Road 295 El Dorado AR 71730-8742 | |
| (870) 315-5137 | |
| Not Available |
| Full Name | The Illumination Foundation |
|---|---|
| Speciality | Clinic/center |
| Location | 248 Union Road 295, El Dorado, Arkansas |
| Authorized Official Name and Position | Shannon Nicole Smith (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8703155137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Illumination Foundation 248 Union Road 295 El Dorado AR 71730-8742 Ph: () - | The Illumination Foundation 248 Union Road 295 El Dorado AR 71730-8742 Ph: (870) 315-5137 |
| NPI Number | 1982330452 |
|---|---|
| Provider Enumeration Date | 07/27/2022 |
| Last Update Date | 07/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982330452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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